Review Article

Laboratory Measures for the Diagnosis, Clinical Management, and Evaluation of Treatment Response in Multiple Myeloma

Sandra E. Kurtin, RN, MS, AOCN®, ANP

From The University of Arizona and Arizona Cancer Center, Tucson, Arizona

The author has no conflicts to disclose.

Correspondence to: Sandra Kurtin, RN, MS, AOCN®, ANP-C, Arizona Cancer Center, 3838 N. Campbell Ave, Tucson, AZ 85719. E-mail: skurtin@umcaz.edu


J Adv Pract Oncol 2010;1:197–206 | DOI: 10.6004/jadpro.2010.1.3.4 | © 2010 Harborside Press


  

ABSTRACT

Tumor markers include substances secreted by or in response to tumor cells and are measured in tissue or other body fluids. Biomarkers have been most widely used in the diagnosis and evaluation of treatment response in solid tumors, such as prostate-specific antigen (PSA) for prostate cancer and CA-125 for ovarian cancer. The use of tumor markers in hematologic malignancies has been limited. Advances in hematopathology including genetic and molecular analysis have provided insight into the pathobiology of hematologic diseases including multiple myeloma (MM). No single biomarker is known for the diagnosis or ongoing monitoring of MM; instead, laboratory measures pointing to genetic and molecular attributes provide the basis for diagnosis, staging, risk-adapted treatment selection, and ongoing evaluation of response. Clinical management guidelines recently proposed by the National Comprehensive Cancer Network (NCCN), International Myeloma Foundation (IMF), and Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) have been modified to include these attributes. Familiarity with these updates is necessary for the advanced practitioner involved in the clinical management of the patient with MM. Laboratory measures used for the diagnosis, clinical management, and evaluation of treatment response in MM will be reviewed, with current recommendations for frequency of monitoring and clinical interpretation.


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